In many areas of human endeavor (arts), including medicine (human and veterinary, and particularly specialties therewithin), the biological sciences, geology, automobile repair, etc., it is necessary to diagnose a condition or event from the universe of known conditions or events relating to that art. The use of a computer to assist in that diagnosis has long been considered desirable, and in many art areas computers are used in one form or another to facilitate diagnosis. For most arts, however, truly effective computer utilization to effect diagnosis is still not a reality. In some situations this is due to an inability to effectively use the search and comparison functions of a computer because an appropriate data base is difficult to construct and/or utilize.
According to the most basic aspects of the present invention, a new tool is provided for constructing and utilizing data bases that may be searched and analyzed by a computer in an effective manner, coined "Diagnostic Mapping Language", or DML. The basic concept behind DML is that all events or conditions have characteristic markers that make them unique and therefore identifiable. A novel grammar is utilized so as to build a data base of individual master maps, each master map corresponding to a condition or event to be diagnosed. A diagnosis is secured by a methodical description of its markers, and by utilization of a computer to compare the markers of a condition or event to be diagnosed with the individual master maps to determine the degree of resemblance between the description input and the conditions or events represented by the master maps.
The DML grammar is based upon three classes of words, namely:
Main: word that describes the most important feature of a sentence. In the case of a medical text it may be an organ, a body part, a secretion, a chemical, etc.
Descriptor: a word that further describes the Main word, by adding a qualification.
Complement: a word that further describes the Descriptor by adding a qualification.
In the description of the invention which follows, diagnosis of a human medical condition using a data base containing a plurality of master maps of medical conditions within a particular specialty (such as nephrology) is provided. However, it should be understood that the principles utilized in the examples are applicable to many other arts where a diagnosis is desired, including the veterinary medicine, biological sciences, geology, and automotive repair arts given as examples above. In the examples that follow some features of human medicine interface with computer technology are also provided that are not necessarily based upon the effective utilization of DML to construct and access data bases, but rather have advantages that are applicable to the effective practice of medicine using a computer regardless of the manner in which the data base is constructed or accessed.
According to the broadest aspects of the present invention, a method of creating a computer searchable data base for use with a computer having a display screen, an input device (e. g. keyboard, mouse, voice responsive signal generator, or any other conventional or known device for putting data or commands into a computer), and processor, for ultimately diagnosing a condition or event from a large plurality of possible conditions or events that may exist in a particular art. The method comprises the steps of: (a) Determining what key words (including, possibly, phrases) describe the characteristic features of each of the possible conditions or events of the large plurality of possible conditions. (b) Creating in computer searchable form a master map for each of the large plurality of possible conditions or events using the key words (including, possibly, phrases) from step (a) that accurately describe each of the conditions or events, to provide a data base containing all the master maps. And (c) providing search access to the master maps data base in the computer so that by a user manipulating the input device to provide a narrative containing some of the key words from step (a), the computer processor will compare the key words input to the key words associated with each master map to determine what conditions or events represented by master maps having the highest degree of similarity with the narrative input, and display those conditions or events on the display screen.
Step (a) may be practiced by dividing the key words into three different classifications of words, main words that describe the most important feature of a sentence that accurately describes an aspect of a condition or event, descriptor words that further describe a main word by adding a qualification, and complements that further describe a descriptor by adding a qualification. Step (b) may be practiced by providing a plurality of distinctly searchable elements for each condition, each element including at least a main word, and where they accurately exist, a descriptor and complement associated with that main word. Step (b) may be further practiced by assigning to each of the elements one of at least two possible logics, a first logic that requires a main and at least a descriptor to also be present before the element is recognized by the processor when searching the data base, and a second logic that requires only the main to be present, but recognizes a descriptor and complement if present.
Steps (a) and (b) may also be practiced by assigning key words to laboratory test results related to each condition or event, including the name of a test, the normal numerical value of the test results if the condition or event doesn't exist, and a flag indicating that the value of inputted data is above normal, below normal, or text including at least one of normal, abnormal, positive, negative, absent, or present. Steps (a) and (b) may also further be practiced by assigning either a "yes" or "no" to individual imaging possibilities related to a particular condition.
The art may be a human medical specialty, where the conditions or events are possible diseases or medical conditions of that medical specialty, and where the main words describe the anatomy or body fluid or tissue involved with the disease or medical condition to be addressed, the descriptor describes the deviation from normal of the main word, and the complement adds specificity to the main or descriptor words. In that case, step (c) may be practiced by placing the master maps data base on a CD ROM along with biopsy images, medical imaging images, or both biopsy images and medical imaging images, associated with a plurality of the master maps, the images capable of display on the display screen by the user manipulating the input device.
According to another aspect of the invention, a method of diagnosing a condition or event from a large plurality of possible conditions or events that may exist in a particular art, each condition or event being provided in a master map which describes that condition or event using a plurality of art specific key words, is provided. The method is practiced using a computer having a display screen, input device, and processor, and comprises the following steps: (a) Providing search access to the master maps data base in the computer so that by a user manipulating the input device to provide a narrative containing some of the key words from the master maps, the computer processor will compare the key words input to the key words associated with each master map. (b) Using the input device, inputting a narrative description that can facilitate diagnosis, the narrative description using some of the key words. (c) Using the input device, activating the computer processor to recognize the key words from the input narrative description, compare the key words to the key words of each of the master maps, to determine what conditions or events represented by master maps have the highest degree of similarity with the narrative input. And (d) displaying on the display screen at least the two conditions represented by master maps having the highest degree of similarity with the narrative input.
In the practice of this aspect of the invention, each master map may have key words divided into three different classifications of words, main words that describe the most important feature of a sentence that accurately describes an aspect of the condition or event associated with that master map, descriptor words that further describe a main word by adding a qualification, and complement words that further describe a descriptor by adding a qualification, each master map having a plurality of distinctly searchable elements for each condition or event, each element including at least a main word, and where they accurately exist, a descriptor and complement associated with that main word, some of the key words being weighted but the majority of key words having a common value. In this case, step (c) is practiced by counting the weighted number of key words within searchable elements in each master map which also appear in the narrative input in step (b), the master map having the highest weighted number of key words within searchable elements being determined as having the highest degree of similarity, and the condition or event associated with that master map therefore considered to have the highest probability of being the correctly diagnosed condition or event.
Also according to this aspect of the invention, each master map may have assigned to each of the elements one of at least two possible logics, a first logic that requires a main and at least a descriptor to also be present before the element is recognized by the processor when searching the data base, and a second logic that requires only the main to be present, but recognizes a descriptor and complement if present. In this case, step (c) is practiced by: searching with the processor for those first logic elements identified as corresponding to both main and descriptor key words in the narrative description before selection, and then counting the main, descriptor, and complement words associated with those first logic elements; and searching with the processor for those second logic elements identified as corresponding to a main key word in the narrative description and then counting the main words, and any descriptor or complement words associated therewith, of the second logic elements.
Especially where the plurality of possible conditions or events are medical conditions or diseases in a medical specialty (although applicable to other art areas as well), the data base provided in step (a) may also include key words assigned to laboratory test results related to each disease or medical condition, including the name of a test, the normal numerical value of the test results, and a flag indicating that the value of inputted data is above normal, below normal, or text including at least one of normal, abnormal, positive, negative, absent, or present; and values of yes or no assigned to individual imaging possibilities related to a particular disease or medical condition. In this case step (c) is also practiced by searching the relevant laboratory test results and imaging values. The data base may also include biopsy images, medical imaging images, or both biopsy images and medical imaging images, associated with a plurality of the master maps, the images capable of display on the display screen by the user manipulating the input device. In this case, the method may comprise the further step, after step (d), of using the input device to select biopsy or medical imaging images capable of display associated with the diseases or medical conditions determined as having the highest degree of similarity, and displaying those images on the display screen.
In the practice of medicine, it is of course especially important for a doctor to properly diagnose a disease or a medical condition, and then to prescribe the correct treatment. At intermediary stages it is also necessary for a physician to be able to know what tests (chemical or physical), or what imaging techniques (such as X-ray, MRI, etc.), to employ to ensure proper diagnosis of the disease or condition.
In order to facilitate effective diagnosis of medical conditions and diseases, it has long been considered desirable to be able to employ computer equipment, software--even more desirable than in the other arts discussed above, and data bases to assist a physician. While computer-aided medical diagnostics have been attempted or employed in a wide variety of circumstances, the practical implementation of computer-aided techniques, especially for diseases or conditions that typically can only be diagnosed and effectively treated by a medical specialist (such as a urologist, gastroenterologist, endocrinologist, hematologist, cardiologist, or osteopath), has fallen short of expectations. This may in part be due to the inability to effectively meld medical and computer language or techniques, the inability to provide all of the potential information that would be useful to a specialist in making a diagnosis or in effecting treatment, or the utilization of data bases that are not specialized or complete enough. In any event, the invention seeks to effect practical realization of the utilization of a computer and associated data base for facilitating the diagnosis, and typically subsequent treatment, of diseases or medical conditions.
Although it has broader medical applicability, the invention is particularly designed to be used by a specialist (urologist, osteopath, etc.), and is particularly advantageous because it contains a wide variety and depth of information that, when utilized by a specialist, can very effectively and accurately narrow the particular disease or medical condition that a patient suffers from, while providing other alternative diagnoses. The invention is also advantageous not only because it can accomplish the functions set forth above, but because it can be used as a training tool or resource by a physician to enhance his or her understanding of a wide variety of medical conditions or diseases, how they differ, how to effect treatment once diagnosed, and where to locate worthwhile information which enhances understanding.
In the use of DML to construct medical data bases the "main" words usually describe the anatomy or body fluid or tissue or chemical involved with the disease or condition to be addressed, such as "liver, urine, or biopsy". The "descriptor" usually describes the deviation from normal. For example "enlarged, rapid, decreased". The "complement" adds specificity to the main and descriptor elements, typically being an adjective which enhances understanding of the main or descriptor elements. For example if normal medical file language is that a patient complains of right sided colicky pain and dysuria, the main component would be "sided", the descriptor "pain", and the complement "colicky", all of which might ultimately lead to a diagnosis of nephrolithiasis, acute pyelonephritis, polycystic kidney disease, or the like.
The invention also utilizes chemical or physical test data in addition to patient symptom and sign information, family history, and imaging (such as X-ray, MRI, etc.) data. All data is acted upon by a computer processor to determine degree of resemblance with individual master maps for the possible universe of diseases or conditions. According to the invention all of the information may be prompted and/or displayed in readily viewable and understandable (to a physician) format, and in a manner that allows comparison of actual biopsy or imaging data to known biopsy or imaging data for patients known to have the particular disease or condition diagnosed.
According to another aspect of the present invention a method of facilitating diagnosis of medical conditions and diseases (e.g. specialty related) using a computer having a display screen, input device, and processor, and connected to a data base of detailed medical information (e.g. a specialty data base, such as nephrology including a plurality of master maps, one for each known medical condition to be evaluated), is provided. The method comprises the steps: (a) Using the keyboard, inputting into the computer a medical description of a patient's history and physical information, including signs and symptoms, using simple medical file language. (b) Displaying chemical and test data information on the screen to prompt entry of available chemical and test data for the patient. (c) Using the input device, entering all relevant chemical and test data in response to the prompt from step (b). (d) Displaying a plurality of imaging option selections on the screen in yes/no format. (e) Using the input device, entering known imaging data in yes/no format in response to the display in step (d). (f) Using the processor, searching the data base of detailed (e.g. specialty) medical information to determine the degree of resemblance between the data input and each of the master maps, and ranking the possible diagnoses based upon the degree of resemblance. And, (g) displaying on the screen at least the two (preferably three, with two other possibilities) most probable diagnoses based upon the degree of resemblance determined in step (f), and in order of the degree of resemblance.
Preferably step (g) is practiced to display possible diagnoses in the form of horizontal bar graphics in which the bar graph is a first color in a horizontal field and the diagnosis corresponding to the bar graph is also in the horizontal field in a second color, different than the first color, the length of the bar graphics being proportioned to the probability of the diagnosis.
The method also preferably comprises the further step (h) of displaying at least one of biopsy and imaging icons that may be selected to provide pictorial information displayed on the screen corresponding to a selected one of the diagnoses displayed on the screen. Typically steps (g) and (h) are practiced to highlight one of the diagnoses and to display a biopsy and imaging icon associated with the highlighted diagnosis. Also the method may comprise the further step (i) of automatically displaying on the screen textual information corresponding to the highlighted diagnosis, and allowing the display of additional textual information to be selected; and step (h) is preferably further practiced by displaying the biopsy and imaging icons as actual biopsy and imaging pictorial representations of the diagnosis highlighted, each icon taking up less than one third the screen before selection thereof. The method may also comprise the further steps of providing zoom and marking functions within a displayed biopsy or image corresponding to a highlighted diagnosis upon selection of the biopsy or imaging icons.
The invention also preferably comprises the further step (j) of, in response to a prompt displayed on the screen, inserting historical information into the computer using the keyboard device and step (f may be practiced to use the historical information inserted in step (j) in determining the order of display in step (g).
Steps (b) and/or step (g) are preferably further practiced to display a "TESTS" icon which, upon selection, displays tests to be performed in order to confirm a selected diagnosis. Also preferably steps (d) and (e) are practiced, and the imaging object selection is preferably provided in, yes/no/empty format. That is each imaging option will have a "yes" or a "no" value, or in some selected instances may be "empty" (that is having neither a yes or a no value).
The invention may also comprise the further steps, during the practice of at least one of steps (b), (c), (d) and (e), of displaying an alphabetical keyboard image on the screen, and (n) using the input device, selecting a letter from the alphabetical keyboard image to display on the screen a listing of chemical or test data, or imaging options, starting with the letter selected.
According to another aspect of the present invention a method of facilitating diagnosis of specialty related medical conditions or diseases using a medical data base is provided. The method may comprise the steps of: (a) Using the input device, inputting into the computer a medical description of a patient's history and physical information, including signs and symptoms, and any relevant available chemical and test data and imaging information. (b) Using the processor, searching the data base to determine the most likely possible diagnosis. (c) Displaying on the screen at least the two most probable diagnoses located in step (b). And, (d) substantially simultaneously with step (c), displaying on the screen textual information, and at least one of biopsy and imaging icons, corresponding to a selected diagnosis, the biopsy and imaging icons, if selected, displaying on the screen actual pictorial representations of actual biopsies or images associated with the diagnosis selected.
In this aspect of the invention there preferably is the further step (e) of displaying on the screen, in comparative format, biopsy or imaging pictorial representations corresponding to more than one diagnosis from step (c). Also the details of the particular steps may be generally as described above with respect to the previous aspect of the invention.
The preceding aspects of the invention are primarily related to the analytical techniques that are utilized according to the present invention. While those may be the only techniques utilized, the invention may also be designed so as to additionally (or alternatively) be operable in a catalog mode which does not require the entry of real live information in order to be utilized by a physician and students, but rather may be used by a physician for education or practice diagnoses, i.e. as a resource.
When the catalog aspect of the present invention is utilized, either in addition to or instead of the analytical aspects, there is provided a method of providing specific categorized information relating to medical information using a computer having a display screen, and input device and connected to a data base of medical information. The method comprises the steps of: (a) Displaying on the screen the options of biopsy, imaging, management, and bibliography relating to a particular disease or medical condition. (b) Using the input device selecting the biopsy option to display pictorially on the screen actual biopsy pictorial representations of the particular disease or medical condition. (c) Using the input device selecting the imaging options to display pictorially on the screen actual imaging pictorial representations of the particular disease or medical condition. (d) Using the input device selecting the management option to display on the screen a condensed opinion and textual information about how to understand and treat the particular disease or medical condition. And, (e) using the input device selecting the bibliography option to display on the screen a listing of suggested readings related to pathogenesis and therapy for the particular disease or condition.
According to this aspect of the invention, the invention also preferably comprises a method wherein steps (b) and (c) are further practiced by displaying zoom and marking functions on the screen, and using the input device, selecting the zoom or marking functions to effect increase or decrease in the size of any particular area of the biopsy or imaging pictorial representations displayed, or to effect marking of any desired portion of the biopsy or imaging pictorial representations displayed.
According to another aspect of the invention a method of providing specific categorized information relating to medical information using a computer having a display screen, CD ROM, and input device, and connected a data base of medical information on a CD which is utilizable by the CD ROM, is provided. The method comprises the following steps: (a) Displaying on the screen an analytical option and a catalog option. (b) Using the input device, selecting the analytical option to bring up screens allowing the input of a patient's history and physical information, including signs and symptoms, chemical and test data, and imaging data, that may contribute to an accurate differential diagnosis. (c) Using the input device entering the known information from step (b). (d) Searching the CD data base with the computer to match the information entered with known disease and medical condition information contained in the CD data base. (e) Using the input device, selecting the catalog option to display on the screen options relating to an opinion about how to understand and treat a disease or condition, reading material relating to a selected disease or condition, and at least one of biopsy and imaging information relating to a selected disease or condition. And, (f) using the input device, selectively displaying the at least one of biopsy and imaging information from the CD in pictorial form on the display screen, which biopsy or imaging information relates to a selected disease or condition.
It is the primary object of the present invention to provide effective computer-aided methodology for diagnosis of all types of conditions or events, and particularly all (including obscure, and specialty related) human medical conditions and diseases, as well as providing a practicing specialist or other physician with such detailed information that the computer-aided techniques according to the invention will be effective in virtually all circumstances to greatly facilitate the physician's ability to diagnose, and typically also treat, a medical condition or disease. This and other objects of the invention will become clear from an inspection of the detailed description of the invention and from the appended claims.